Ellipsoid zone integrity affects visual acuity outcomes in wet AMD
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NEW YORK — Ellipsoid zone integrity is a major driver of visual acuity outcomes in eyes with neovascular age-related macular degeneration without intraretinal fluid.
“As we know, in eyes with neovascular AMD, the goals for fluid management continue to be a little bit controversial. The presence of intraretinal fluid throughout anti-VEGF treatment has been associated with poorer visual acuity outcomes,” Justis P. Ehlers, MD, FASRS, said at the American Society of Retina Specialists annual meeting. “But somewhat surprisingly, we’ve seen in multiple studies, including the CATT study as shown here, that some retinal fluid has been associated often with better visual acuity outcomes, even compared to eyes that were dry.”
In a phase 3 clinical trial, Ehlers and colleagues assessed the association between best corrected visual acuity with exudative volatility, ellipsoid zone integrity and retinal fluid in 652 eyes with neovascular AMD using a machine learning-enhanced extraction system. The best visual outcomes, Ehlers said, were observed in eyes without fluid that maintained ellipsoid zone integrity (78 letters), significantly better than the eyes with subretinal fluid (68 letters; P < .0001).
An in-depth compartmental OCT assessment offers insights into structure-function correlation for the impact of fluid as well as underlying atrophy for visual outcomes, Ehlers said.
“The presence of subretinal fluid may not be a benign finding, particularly with high volatility in maximizing fluid resolution, and overall stabilization may be important to maximize outcomes,” he said.
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Ehlers JP, et al. Higher order OCT feature assessment of the impact of fluid dynamics on visual acuity in neovascular AMD in a phase III clinical trial: The importance of outer retinal integrity. Presented at: American Society of Retina Specialists annual meeting; July 13-16, 2022; New York.
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